Nokea
The x-ray shows that the patient's fracture is at the remodeling stage. What characteristics of the fracture healing process are happening at this stage (select one that doesn't apply)?
- A. Radiologic union
- B. Absorption of excess cells
- C. Return to preinjury strength and shape
- D. Semisolid blood clot at the ends of fragments
Correct Answer: D
Rationale: During the remodeling stage, radiologic union occurs, excess cells are absorbed, and the bone returns to its preinjury strength and shape.
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The nurse will document which reflex is present when there is dorsiflexion of the great toe with fanning of other toes?
- A. Brudzinski
- B. Babinski (damage to the corticospinal tracts)
- C. Trousseaus
- D. Kernigs
Correct Answer: B
Rationale: The Babinski reflex, characterized by dorsiflexion of the great toe and fanning of the other toes, is abnormal in adults and indicates damage to the corticospinal tract. This reflex is normal in infants but disappears as the nervous system matures. Its presence in adults suggests neurological pathology.
Which of the following can NOT be prevented with a vaccine?
- A. tetanus
- B. pneumococcal meningitis
- C. meningococcal meningitis
- D. listeriosis
Correct Answer: D
Rationale: The correct answer is D: listeriosis. Listeriosis is caused by a bacterium and there is currently no vaccine available for it. Tetanus, pneumococcal meningitis, and meningococcal meningitis, on the other hand, are all preventable with vaccines. Tetanus is prevented by the DTaP vaccine, pneumococcal meningitis by the pneumococcal conjugate vaccine, and meningococcal meningitis by the meningococcal vaccine. Therefore, listeriosis is the only condition among the options that cannot be prevented with a vaccine.
The nurse practitioner is assessing an adult patient with a seizure disorder that is well controlled on phenytoin (Dilantin). What new finding indicates that a phenytoin drug level assessment is needed?
- A. Hypertrophic gums
- B. Vitamin D supplements
- C. BP 125/78 mmHg and pulse 95 bpm
- D. Flat affect and anxiety
Correct Answer: D
Rationale: The correct answer is D because a flat affect and anxiety can indicate potential phenytoin toxicity, which warrants a drug level assessment. Phenytoin toxicity can manifest as neurological symptoms such as mood changes and cognitive impairment. Options A and B are unrelated to phenytoin levels. Option C indicates normal vital signs and is not a specific indicator of phenytoin toxicity.
A myelogram is ordered for Mr. Tucker to determine the extent of injury. Which of the following would be avoided following this procedure?
- A. Watching him for a possible sensitivity reaction
- B. Elevating his head and thorax 15-30° for 8 hours
- C. Restricting fluid intake for 12 hours
- D. Administering aspirin for headache
Correct Answer: C
Rationale: Fluid restriction can increase the risk of complications after a myelogram.
A client with a skeletal traction reports a throbbing pain. Which of the following actions should the nurse take to relieve the pain?
- A. Administer antibiotics
- B. Elevate the extremity
- C. Petal cast edges with waterproof tape
- D. Massage the area of pain
Correct Answer: B
Rationale: Elevation can help reduce pain by decreasing swelling.